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6.69 per 1,000, and Catford Ward in Lewisham 6.55 per 1000,
were most affected, while Lewisham Village, 2.62 per 1,000, was
the most fortunate ward.
From the Street List the portions of the Borough most
affected may be noted. The 637 actual cases were distributed
over 466 houses.
In relation to age periods the highest number of cases
occurred between the ages of 5 and 15 and 1 and 5 years, while
the lowest number was recorded to children under one year.
Return Cases.—Of the 492 cases removed to Hospital, we
were informed that 50 were considered " return cases," i.e., a
patient discharged from Hospital to its home apparently well
(although the child may have been several weeks in hospital),
within a few days of its return other members of the
family contracted the illness, and in their turn were removed.
After enquiry, there appears little doubt that discharged patients
conveyed the infection in several instances.
No doubt every care was taken by personal disinfection
and medical inspection to prevent the discharge of
children still infectious. I am of opinion, however, that the
chances of return cases will be reduced by the system recently
adopted of placing children in a ward free from actual cases of
Scarlet Fever for some days prior to their discharge. In this
way the danger of leaving wards full of infection will be
obviated. The detention of children in a convalescent hospital
for a short period prior to their return home would be a great
advantage.
Of the 637 cases, 17, or 2.6 per cent. of the total proved
fatal.